Volunteer Application Volunteer Application Today's Date - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Name * Required First Last Address * Required Street Address City State / Province / Region ZIP / Postal Code Birthdate - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Email * Required Preferred Phone * RequiredWhat languages do you speak? * RequiredHave you ever been convicted of a crime (excluding traffic violations)? * Required Yes No Are you currently employed? * Required Yes No If you are employed, who is your current or most recent employer?Are you retired? * Required Yes No College or University Attended:Post Graduate Education:Special Training or Certificates:High School/GED AttendedAre you currently attending high school? Yes No Is volunteering a school service requirement? Yes No Is volunteering a Bar or Bat Mitzvah project? Yes No What motivates you to want to volunteer with older adults? * RequiredAvailability for Volunteering - Day(s) of the Week and Time(s) of Day * Required Monday Tuesday Wednesday Thursday Friday Sunday Please check the areas in which you would be interested in volunteering: * Required Individual (1:1 assistance or companionship) Group activities Holiday celebrations Teaching a class (such as exercise, art, poetry, cooking, music, entertainment, etc.) Other Reference One (Name/Phone Number/Email Address)Reference Two (Name/Phone Number/Email Address)Person to Notify in Case of Emergency/Relationship to YouEmergency Contact Cell Phone Number/Email AddressDigital Signature First Last Applicants under the age of eighteen must have this Application signed by their parent or guardian. The above listed applicant has my permission to volunteer at Kavod Senior Life.Parent/Legal Guardian Digital Signature: First Last
